Consensus statement: Diagnosis and therapy of depression.

In recent years there has been a considerable effort undertaken to produce clinical practice guidelines and consensus statements about the diagnosis and treatment of depression, with specific focus on primary care. We report on the firstly undertaken effort for such an endeavor in Austria. The discussion on this theme has been facilitated by the introduction of operationalized diagnostic instruments (ICD-IO and DSM-IV). For the treatment of depressions with antidepressants, the necessity for a favorable side-effect profile has been stressed. At present, the latter is true for the group of selective serotonin reuptake inhibitors (SSRI) and reversible inhibitors of monoamino oxidase A (RIMA). Furthermore, it has been substantiated that the high risk for relapse (up to 80% within 1 year) necessitates a long-term treatment for both unipolar and bipolar depression. The role of psychotherapy includes the need of knowledge about diagnosis and course of the illness with a subsequent information for the patient within a supportive therapy. Within the more specific psychotherapies, empirical data are available for cognitive and interpersonal therapy. Although the content of these documents does not vary by a large degree, there is still a disagreement about several issues, mostly regarding first-choice antidepressant drug treatment for acute and long-term management in depression.